La Tonya Nicole Brown
WELLSPRING FAMILY MEDICINE, PA


Address: 110 Atrium Way, Columbia, SC 29223-6301
Phone: 8038659655

La Tonya Nicole Brown (NPI# 1023064920, PAC ID# 4183899883) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1023064920
PAC ID by PECOS 4183899883
Professional Enrollment ID I20111207000891
Full Name La Tonya Nicole Brown
Organization Legal Name WELLSPRING FAMILY MEDICINE, PA
Address 110 Atrium Way
Columbia
SC 29223-6301
Phone Number 8038659655
Gender F
Graduation Year 1999
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 6709987860
Number of Group Practice Members 2
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
420018 PALMETTO HEALTH RICHLAND

Other Locations

Address Phone Organization
110 Atrium Way, Columbia, SC 29223-6301 8038659655 WELLSPRING FAMILY MEDICINE, PA

Organization Information

Organization Legal Name WELLSPRING FAMILY MEDICINE, PA
Physicians 1

Office Location

Street Address 110 ATRIUM WAY
City COLUMBIA
State SC
Zip 29223-6301

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Competitor

Search similar physicians

City COLUMBIA
Zip Code 29223
Specialty NURSE PRACTITIONER
City + Specialty COLUMBIA + NURSE PRACTITIONER

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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